Clinical Observation On The Preventive Effect Of Two Ways Of Using Cefuroxime Sodium On Intraocular Infection After Cataract Surgery

Objective:The clinical effects of cefuroxime sodium in the prevention of intraocular infection after cataract surgery were compared,and the safety of using cefuroxime sodium solution in the perfusate was evaluated.Methods:Ninety eyes of ninety patients who underwent phacoemulsification surgery at Jingzhou Central Hospital between December 2019 and September 2020 were divided into groups:45 eyes in group.In the anterior chamber administration group,the patients were received the intracameral injection of 10g/L 0.1ml cefuroxime sodium solution by the surgeon in the end;patients in the perfusion fluid administration group received BBS with cefuroxime sodium(1.5g/L)during surgery performed.Conjunctival sac samples were collected and submitted for examination on the day of admission,and routine antibiotic eye drops were used after admission.Conjunctival sac samples were collected for examination after conjunctival sac disinfection before operation,and aqueous humor samples were taken for examination after operation.The operation is arranged after improving the preoperative specialist examination,routine biochemical examination.The same experienced and skilled doctor used Alcon’s Centurion phacoemulsification system to operate.After the operation,Pranopolin and Tobra Dex eye drops were applied four times a day,and Tobra Dex eye ointment was applied once a night,for three weeks,the slit lamp,intraocular pressure,and visual acuity were checked on the first day after the operation.The patients were followed up for 1 week,1 month,and 3months after the surgical treatment,followed up to check the best-corrected visual acuity,non-contact intraocular pressure,OCT,corneal endothelial count.Results:The results of the three specimens in the two groups were analyzed,and the results showed that the total positive rates of specimen culture in the two groups were19.3%and 21.5%,respectively.The positive rates of the three specimens in the two groups were not statistically significant(P>0.05).The positive rates of the three specimens in the two groups were statistically significant(P<0.05)The rate of positive samples in aqueous humor was significantly lower than that in the conjunctival sac group.Before antibiotic eye drops,the positive rates of conjunctival sac specimens in the two groups were 46.7%and 51.1%respectively,and the disparity in the positive rate was not statistically significant(χ~2=0.178,P=0.673>0.05).Preoperative results of conjunctival sac specimens in the two groups were also not statistically significant(χ~2=0.104,P=0.748>0.05),the culture results of aqueous humor samples from both groups were negative.The samples of conjunctival sac before and before antibiotics in the anterior chamber administration group were statistically significant(χ~2=13.846,P<0.05),significant differences in the perfusion were observed for conjunctival sac vs administration of antibiotics group(χ~2=14.703,P<0.05).During the follow-up,the mean macular fovea thickness was 244.84±15.4um in the anterior chamber administration group and 244.91±20.0um in the perfusion group,the difference between the means was not statistically significant.No significant difference in the thickness of macular fovea was detected before operation vs the follow-up results of 1 week,1 month,and 3month in both groups.The comparison was made within the change group of the average thickness of the macular center in the anterior chamber administration group.One month after the operation,the mean macular fovea thickness was 257.24±15.8um.The difference between preoperative and postoperative changes in the thickness of 1 week,1 month,and 3 months did reach statistical significance(P<0.05).The maximum mean of macular center concave in the first month after surgery was 257.78±17.6um,and the difference between preoperative and postoperative changes in 1week,1month,and 3month thickness was statistically significant(P<0.05).The average corneal endothelial count of the two groups before the operation was 2491.10±237.8mm~2 and 2535.21±276.5mm~2,respectively,but this difference between the two groups was not statistically significant(P>0.05).Corneal endothelial cells were compared between the two groups at 1week,1month,and 3month after surgery,and there was no statistically significant difference(P>0.05).The significant difference in the corneal endothelial count was detected before operation vs the follow-up results of 1 week,1 month,and 3month in each group(P<0.05).The number of corneal endothelial cells in both groups after surgery was significantly reduced compared with that before surgery,and both groups lost the most in 3month after surgery.None of the patients had intraocular infection after cataract surgery,there no Cystoid macular edema and corneal endothelial decompensation during follow-up.Conclusion:Both methods of using cefuroxime sodium to prevent bacterial contamination of aqueous humor are effective.The follow-up results of the small sample size in this article suggest that adding cefuroxime sodium to the perfusate is as safe as using cefuroxime sodium in the anterior chamber.In order to avoid the risk of contamination in the two-step dilution method during the anterior chamber administration,cataract surgeons may consider using the perfusion solution to prevent endophthalmitis after cataract surgery.